Tobacco use is associated with more than 400,000 premature deaths each year in the U.S. Thirty percent of all cancer deaths are due to tobacco. Treatment of nicotine dependence has been recognized as an important means of decreasing cancer deaths and effective intervention programs have been supported by the NCI since the late 1980s. Now, with more effective treatment offerings, an increasing number of pharmacologic agents, and financial resources from the recent settlements with the tobacco industry, the demand for education in nicotine dependence treatment is growing. The Mayo Nicotine Dependence Center, established in 1988, has a long history of very successful educational programs supported by an equally successful clinical program that has treated over 21,000 patients. However, the demand for our clinical and educational services, plus our desire to meet the needs locally and nationally, now requires additional funding. Building on our experience with a nationally recognized annual seminar on nicotine dependence treatment and program development and our successful internal medicine residency curriculum, we propose to provide a broad-based educational program including one-day workshops to train health care professionals in the USPHS Clinical Practice Guideline - Treating Tobacco Use and Dependence recommended intervention program, intervention training for physicians in training, continuation of our three and one-half day CME seminar, extended CME seminar specialty training for health care professionals who desire additional training, and a three month practicum in Nicotine Dependence for Master's candidates. We will also collaborate with The Mayo Medical School, The Mayo School of Health-Related Sciences, and The Mayo Graduate School to strengthen the nicotine dependence treatment curriculums of health professionals in training. All of the programs will be carefully evaluated for efficacy and quality improvement.